Quintessence International, 08/2019

Objective: To compare the clinical performance of two glass-ionomer cements in combination with two light-cured coatings in Class II cavities. Method and materials: In total, 43 Equia Fil/Equia Coat and 42 Fuji IX GP Fast/Fuji Coat LC restorations were placed, in 34 patients. Only Class II cavities with two- or three-surface restorations were included. The clinical performance was evaluated at baseline, after 1, 2, and 3 years using the FDI criteria. For the statistical analysis, Fisher exact test, Wilcoxon signed-rank test and Mann-Whitney U test were applied. The success and survival of the restorations were calculated with the Kaplan-Meier method and a log-rank test was used to detect significant differences between the tested materials. Results: At the 3-year recall, no significant differences could be detected between the two glass-ionomer cements for any of the evaluated criteria (Mann-Whitney U test, P > .05). When comparing the baseline with the recall data at 3 years for each material separately, significant changes could be observed in both materials for the criteria "surface luster," "fracture of material and retention," and "approximal anatomical form" (Wilcoxon signed-rank test, P < .05). Additionally, the Equia Fil restorations showed a notable change for the criteria "marginal adaptation" (Wilcoxon signed-rank test, P = .039). At the 3-year follow up, the Equia Fil and the Fuji IX GP Fast restorations exhibited an overall survival rate of 86.21% and 84.0%, respectively. Conclusion: The two glass-ionomer cements tested performed similarly in Class II cavities in adult patients, with a moderate to high failure rate after 3 years. (Corrected article published in Quintessence Int 2020;1:e1-e11; doi: 10.3290/j.qi.a43755) Keywords: amalgam alternatives, Class II restorations, clinical study, Equia, FDI criteria, glass-ionomer cement, permanent teeth

Proper gingival displacement is an important prerequisite to obtain good quality impressions. Retraction pastes could eliminate the need for retraction cords, as they have advantages such as comfort reported by patients, faster technique, ease of use, no need for anesthesia, and reduced tissue trauma. The objective of this paper was to present a clinical case of ceramic veneers and crowns in which a retraction paste was used for gingival displacement during both the impression and cementation stages, with 3 years of follow-up. Treatment planning consisted of the replacement of preexisting crowns and ceramic veneers on the anterior teeth. After finishing the preparations, gingival displacement with Astringent Retraction Paste was performed without anesthesia or the use of cords and the impression was taken. Before cementation of the crowns and veneers, the Astringent Retraction Paste was applied. Avoiding the use of cords during cementation prevented trauma. The soft tissue margins remained stable and healthy after a period of 3 years. It can be concluded that retraction pastes could be indicated for displacement of soft tissue when preparation margins are at the gingival level or slightly intrasulcular prior to impressions, restoration cementations, direct restorations, and before relining provisional restorations. Clinical significance: The impression appointment can be traumatic to some patients. The use of cords for gingival displacement usually requires local anesthesia and is time consuming. Retraction astringent pastes instead of cords seems to be a good option for some cases in gingival tissue displacement. Keywords: dental ceramics, dental impression materials, dental impression technique, prosthetic procedure, prosthodontics, restorative dentistry

Objectives: The purpose of this article was to propose guidelines for dental practitioners facing the dilemma whether to treat, follow up, or disregard random asymptomatic radiographic findings. Data sources: Searches performed in MEDLINE, Cochrane, and EMBASE databases were followed by a manual search. Related data incorporated by experts included recommendations on asymptomatic root canal treatment, quality of the root canal, and restoration relative to outcome. Evidence tables were developed following quality and inclusion criteria assessment. Results: The initial search retrieved 2,796 MEDLINE, 542 EMBASE, and 152 Cochrane articles, for a total of 3,490 potential articles. After duplicates were removed, 2,946 articles remained. Articles not related to the topic and not meeting eligibility criteria were excluded, resulting in 44 studies included in this scoping review. Conclusions: The proposed guidelines provide easy access to existing information in endodontics. The findings are common and possess clinical and medico-legal importance. Keywords: asymptomatic periapical lesion, coronal restoration, endodontic success, follow-up, microleakage, outcome

Objective: The objective of this randomized clinical trial was to compare the effect of different NiTi shaping systems on postoperative pain after single-appointment nonsurgical endodontic retreatment. Method and materials: Between September 2016 and December 2016, 99 patients with asymptomatic root canal-treated teeth requiring nonsurgical endodontic retreatment were randomly divided into three groups (n = 33 per group). After removing previous root canal filling, instrumentation was performed using One Shape, Revo-S, and WaveOne systems in groups 1, 2, and 3, respectively. Postoperative pain intensity was assessed at 6, 12, 18, 24, 48, and 72 hours, 7 days, and 1 month after the retreatment. Data were analyzed using one-way ANOVA and Mann-Whitney U and Kruskal-Wallis tests (alpha = .01). Results: Up to 72 hours, postoperative pain was significantly less in group 1 than in groups 2 and 3 (P < .01). From 72 hours to 7 days, postoperative pain was significantly less in groups 1 and 2 (P > .05), compared to group 3 (P < .01). At 1 month, postoperative pain was not significantly different among all three groups (P > .05). Postoperative pain was the highest with WaveOne group. Conclusions: Since One Shape and Revo-S are both based on the rotational approach and WaveOne on reciprocal approach, less incidence of postoperative pain intensity with One Shape and Revo-S in single-appointment nonsurgical endodontic retreatment could be associated with the motion type during root canal shaping. Keywords: continuous rotation, postoperative pain, randomized controlled clinical trial, reciprocating motion, retreatment, single-appointment endodontic retreatment

Objective: To evaluate if short implants without augmentation can be considered a successful alternative treatment modality in the rehabilitation of posterior atrophic ridges when compared to standard-length implants with augmentation. Method and materials: Electronic searches were performed in the PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Randomized controlled trials (RCTs) that compared short implants and standard implants with augmentation were the only articles included. Titles and abstracts were screened, data were extracted, and articles were assessed for risk of bias. Meta-analyses were performed for 13 of the included RCTs that had similar outcome measures. Results: Of the total 17 relevant studies identified, 13 RCTs fulfilled the inclusion criteria. The meta-analysis showed no significant differences regarding the implant failure rate at 1 year (I2 = 67%, P = .13; risk difference [RD]: −0.05, 95% confidence interval [CI]: −0.11, 0.01), at 3 years (I2 = 58%, P = .17; RD: −0.04, 95% CI: −0.01, 0.02), and at 5 to 10 years (I2 = 0%, P = .47; RD: −0.05, 95% CI: −0.19, 0.09). However, the meta-analyses of 10 trials regarding the postoperative complications of short- and standard-length dental implants showed a significantly higher rate of postoperative complications in the standard-length dental implant group at 1 year (I2 = 93%, P = .02; RD: −0.21, 95% CI: −0.39, −0.04). Conclusions: Short dental implants seem to be an effective alternative treatment for the atrophic posterior ridge. The pooled data revealed that short dental implants have statistically less marginal bone loss and fewer postoperative complications when compared to standard-length dental implants with augmentation. However, there are no statistically significant differences in regard to implant failure. Keywords: bone graft, dental implants, implantology, implants, systematic review

Objectives: This randomized clinical trial aimed to compare the effects of a bovine-derived xenograft with (control group, CG) or without (test group, TG) a collagen membrane for the treatment of mandibular Class II furcations. Method and materials: Nineteen patients presenting 32 furcations were included and randomly assigned to CG (n = 16) or TG (n = 16). At the 6-month follow-up (M6), 29 furcations were reevaluated. All clinical measurements were performed by the same investigator with a straight periodontal probe and a specially designed "modified Nabers probe" (both with 1-mm increments). The primary outcome was the improvement of the horizontal probing attachment level. According to the protocol, there was no re-entry at 6 months. Results: Both vertical (at M6, CG: 2.4 ± 0.8 mm, TG: 2.7 ± 1.0 mm) and horizontal probing attachment levels, whether measured with a periodontal probe (at M6: CG: 3.4 ± 0.8 mm, TG: 3.2 ± 1.0 mm) or the "modified Nabers probe" (at M6: CG: 3.5 ± 1.1 mm, TG: 3.2 ± 1.0 mm), favorably evolved after 6 months. There was no significant difference for any of the measures performed (P > .05, unpaired t test). Conclusions: Both treatments were clinically effective with no statistically significant difference between them but as there was no histologic analysis, the amount of real regeneration could not be analyzed. This conclusion should be confirmed by longer follow-up periods. Keywords: bovine-derived xenograft, collagen membrane, furcation defects, periodontal disease, regenerative therapy

Objective: The understanding the etiology of painful temporomandibular disorders (TMD) has evolved over the last eight decades. Evidence-based systematic research had questioned historical concepts and abandoned preconceived dogmas based purely on mechanically based etiologies, transforming TMD into a complex musculoskeletal chronic pain model. Unfortunately, many of these old ideas persist in undergraduate education and the dental community. Revisiting the historical development and the way the etiology of painful TMD has changed over the years may be helpful to understand the complexities of TMD as a group of chronic pain pathologies. Method and materials: A literature search using the MeSH terms: "temporomandibular joint disorders," "TMD," "etiology," "causality," "history," and "evolution" using Medline and Scopus databases was conducted aiming to answer the focused question: "In what ways has etiologic understanding of temporomandibular disorders evolved?" A narrative review was performed with the selected studies, highlighting significant contributions that have transformed TMD from a purely mechanical-based phenomenon into a chronic pain biopsychosocial disease model. Keywords: chronic pain, etiology, myofascial pain, occlusion, pain, temporomandibular disorders, temporomandibular joint